PURPOSE: We investigated whether a rapid diagnosis ofTB Pleural effusions can be established by interferon -y blood and pleural tests in routine clinical practice and assess the level of agreement with the TST.
METHODS: The patient have been separated in two groups: first group, where the diagnosis ofTB has been confmned by positive acid-fast bacilli and culture smear from sputum fluid by tissue biopsy and efficacy of treatment second group not Tb cases. Demographic clinical and microbiological data have been collected.
RESULTS: From a total of 114 patients enrolled 40 cases has been diagnosed with pleural effusions. Five cases has not underwent the measuring ofIFN-y in pleural effusion. The mean of IFN- y level in pleural effusion of all cases was 1.35 ± 0.7, in TB 1.62± 0.80; in cancer 1.57± 0.532.48 and other cases 1.0±0.51. The sensitivity oflFN- y in pleural effusion for diagnosis ofTB was 68.4% and specificity 100%; the positive predictive value of IFN-y in pleural effusion was 100% and negative predictive value 71.4%. The sensibility ofPPD in diagnosis ofTB was 73% and specificity 63.7%; the positive predictive value was 39.5% and negative predictive value 87.9%. In 3 cases with diagnosis of cancer IFN- y in pleural effusion was positive;:; 0.35 There is no correlation between IFN- y in pleural effusion and PPD. According the regression analysis when the value oflFN- y in blood change with one unit the value ofPPD change with 0.5.
CONCLUSION: The concentration of IFN- y in pleural effusion is a good, useful diagnostic marker of tuberculosis and safer than PPD considering clinical presentation and differential diagnosis with malignant and parasite pathology.
CLINICAL IMPLICATIONS: In exudative pleural effision IFN-gamma of blood and effision is recommented.
DISCLOSURE: Jorgjeta Bukli, None.